Telemedicine may provide cost-friendly treatment

PHOENIX — Employers are finding faster ways to deliver health care to injured workers, and the use of telemedicine may be one of the more cost-effective solutions available, say experts.

At the Workers Compensation Research Institute’s 35th annual conference in Phoenix on Friday, a panel of managers and physicians shared their experiences with telemedicine and how it has impacted their ability to get medical care for employees injured on the job.

“There’s been a tremendous rise in patient visits and dollars flowing through telemedicine,” said Dr. David Deitz of Boston-based David Deitz & Associates. While he noted that there’s no quantitative data yet on telemedicine’s use in workers compensation, industry experts believe there’s a significant amount of potential for using telemedicine for workplace injuries.

In February 2018, The Cheesecake Factory Inc. began using telemedicine as an alternative for injured employees. The restaurant company, which has a workforce of more than 40,000, has a fair number of kitchen-related injuries due to its extensive scratch menu, said Kurt Leisure, vice president of risk services.

Many of those injuries happen late at night and on weekends, leaving the emergency room — and often a long stint in the waiting room — as the only option for care, he said.

The Calabasas Hills, California-based company decided to try out telemedicine. After an accident occurs, an employee’s supervisor will call the company’s nurse triage department, which will make the determination whether urgent care is needed, if no further care is required, or whether telemedicine is an option for the worker. If the employee is provided the option of telemedicine and accepts, the employee’s supervisor can initiate the call on the employee’s own mobile device.

“For us, transportation and interruption of the shift is minimal, it’s immediate care, the costs are predictable, and the injury notes transfer right into the claims adjuster system,” Mr. Leisure said. “There’s no waiting room, there’s flexibility of treatment … the 24/7 model works for us.”

Since the program began, approximately 3,000 injury calls have been made to the company’s nurse triage line. About a third ended at triage, 470 were determined to be ripe for telemedicine, and just under 70% of those employees offered telemedicine accepted it, with about half successfully treated without further medical care. Mr. Leisure said the company has saved more than $150,000 in workers comp medical costs since the implementation of the program.

Another benefit, said Mr. Leisure, is that sometimes an employee can go back to work right away in a modified duty capacity, such as being moved from cooking on the line to napkin folding. He also noted that much of the kitchen staff in the company’s restaurants are not native English speakers, but via telemedicine they can often find a bilingual physician.

Dr. Stephen Dawkins, medical director of Caduceus USA in Atlanta, Georgia, noted that large employers may benefit from telemedicine by being able to educate a handful of doctors on the company’s protocols and the demands of the workplace, which he said can allow for better case management and better oversight.

Another, he noted, is the record of the treatment provided due to the recording of the telemedicine visit.

“You have the person describing how they were injured in their own words, which provides a foundation for any migrating symptoms or future claims,” he said. “Case law now supports video as the highest form of evidence.”

At The Cheesecake Factory, Mr. Leisure said his servers have really embraced the ability to see a doctor remotely, but his dishwashers have had the lowest adoption rate of telemedicine.